Taking Note

Public Still Wants Comprehensive Immigration Reform

The public’s continued support for comprehensive immigration reform is being shunted to the side amid all the fuss about Arizona’s draconian new law allowing police to interrogate suspected illegal immigrants at will and detain them if they can’t produce papers. But it is there, as recent polling attests.

In a recent AP-Gfk poll, for example, the public was asked whether it was a good thing or a bad thing that the Obama administration had not yet passed a comprehensive immigration bill. A plurality of 48 percent pronounced this a bad thing, while just 9 percent thought it a good thing (41 percent thought it was neither).

The public particularly wants to see a path to citizenship made available. Fifty-nine percent in the same poll favored “providing a legal way for illegal immigrants already in the United States to become U.S. citizens” compared to 39 percent who were opposed.

Al-Qaeda and the NSS

My colleagues at Democracy Arsenal have discussed many of the overarching themes of the National Security Strategy at length, but I am going to focus on one small portion of the document. I generally have a hard time taking these types of exercises particularly seriously because we kind of already knew what the NSS was going to say. In essence, the NSS seems like a cataloging and recapitulation of themes and arguments that we have heard for years now—first as a critique of the excesses of the Bush administration by then-candidate Obama, and then, more recently, as the operating principles of the administration’s foreign policy. I just don’t find anything particularly revelatory about it, and as a restatement, theNSS does not establish national strategy so much as reflect it, albeit in an aspirational sense.

The Public and Wall Street

As Congress continues to debate the financial regulation bill there are a couple of things it should keep in mind. One is that the public doesn’t trust Wall Street anymore—not even on the level of ordinary investing in the stock market (much less the elaborate financial shenanigans Wall Street firms have recently engaged in). According to the new NBC News/Wall Street Journal poll, just 35 percent now believe that “the stock market is a fair and open way to invest one’s money” compared to 58 percent who do not believe the stock market is now fair and open due to “corporate corruption and broker practices.”

No wonder the public, by 55-38, says they are more concerned that proposed reform of financial regulations will not do “enough to protect consumers and rein in Wall Street” rather than that reform might limit investment opportunities and hurt the country’s ability to compete in financial markets.

The Ominous Increase in High Poverty Schools

Richard Kahlenberg responds to Thursday, May 27th's U.S. Department of Education report on the increase of students attending high poverty schools. Listen to it here:

Click Here to Play Richard Kahlenberg's Response to the U.S. DOE High Poverty Schools Report 

Download The Condition of Education 2010 Report

Shining a Light on Conflict of Interest in Biomedical Research

Last week Francis Collins, the director of the National Institutes of Health proposed important new rule changes for federally-funded investigators that are designed to increase transparency and remove many of the conflicts of interest that abound in biomedical research.

The proposed NIH rules, which are open for comment and expected to go into effect before the end of the year, represent the first time financial reporting requirements have been overhauled since 1995. The rules require investigators to disclose to their institutions all payments they receive from industry above $5,000, as well as any equity position they hold in a company. Research funding, speaking fees, paid authorship and travel expenses all must be part of this accounting. The previous limit was $10,000. The new regulations, which are aimed at reducing or removing industry bias from academic research, also require the academic medical centers to come up with a plan to manage investigator’s conflicts of interest—for example, university officials might insist that an investigator sell stock he owns in a company that helps pay for his research. Institutions will also be required to post all relevant payments (along with names of individual investigators) on a public website.

New York Mayor John Lindsay. Remember Him?

Caption: I'll bet Lindsay never dreamed this would happen!

© Joseph Farris / New Yorker Collection / www.cartoonbank.com

Between John F. Kennedy at the start of the decade and Bobby Kennedy towards its end, in the mid-1960s another charismatic young politician briefly brought energy and promise to public life. He was John V. Lindsay, the liberal Republican congressman from New York's Upper East Side who was elected mayor of New York in 1965. His appeal was forever captured in columnist Murray Kempton's characterization on the day Lindsay started his mayoral campaign: "He is fresh and everyone else is tired." Eight years later, at the end of his second term at City Hall and after a brief run as a Democrat for president in 1972, Lindsay retired. The New York Times Magazine featured his weary face on the cover, with crease lines highlighted by the crises he had encountered, including strikes by municipal workers, budgetary problems, middle-class flight, crime surges, interracial tension over schools and community control, welfare, and a prison riot.

A Bold Move: FDA Suggests Drug-Makers and Device Makers Share Information

When President Obama tapped former Baltimore Health Commissioner Joshua Sharfstein to become Deputy Commissioner of the Food & Drug Administration fourteen months ago, Sharfstein’s harshest critics called him “an inconceivably poor choice.”  They were particularly upset that the administration had “decided to divide responsibilities at the FDA, giving Margaret Hamburg, the newly appointed FDA Commissioner,  responsibility for regulating food and tobacco, while making Sharfstein the point man overseeing drugs and devices.” At first, I was dismayed at the suggestion that the White House had selected a weak candidate to oversee drug-makers and device makers, but as I read why they objected to the appointment, I began to smile.  (See this HealthBeat post.)  Since then, I have been waiting for Sharfstein to make his move.

My  patience was rewarded  last week when I read a “Perspective” in the May 19  New England Journal of Medicine  titled “Transparency at the FDA,” authored by  Dr. Sharfstein and Afia K. Asamoah, J.D., director of the FDA’s Transparency Initiative. What they propose is nothing less than full disclosure of the details of the industry’s clinical trials including “when an application for a new drug or device has been submitted or withdrawn by the sponsor, and whether there was a significant safety concern associated with the drug or device that caused the sponsor to withdraw its application.”   They also recommend making the full text of so-called “complete response” letters from the FDA available. The authors suggest that the public has a right to know how medical products are made—and why the FDA did or didn’t approve a new drug or medical device. Moreover, they argue, if this information is made public, “companies [can] learn from the successes and failures of other products.” Their recommendations are open for comment until July 20.

Rewarding Strivers

In Sunday’s Washington Post Outlook section, I outlined five myths about who gets into college.  The myths include:

1. Admissions officers have figured out how to reward merit above connections and wealth.
2. Disadvantages based on race are still the biggest obstacles to getting into college.
3. Generous financial aid policies are the key to boosting socioeconomic diversity.
4. Selective colleges are too expensive and aren’t worth the investment.
5. With more students going to college, we’re closer to the goal of equal opportunity.

Most of the data in the piece are drawn from a new volume that The Century Foundation will releasing at the National Press Club on June 17 entitled, Rewarding Strivers: Helping Low-Income Students Succeed in College (invitation to the forum is here). The book includes a fascinating chapter by Edward B. Fiske on “The Carolina Covenant,” the University of North Carolina’s innovative program to provide financial aid and support to students earning below 200% of the poverty line.  The volume also has a ground-breaking chapter by Anthony P. Carnevale and Jeff Strohl on growing stratification in higher education and an analysis quantifying (in terms of SAT points) the various economic and racial disadvantages that students face.  The research is a revised and updated version of Carnevale’s controversial strivers research from the late 1990s.  Carnevale and Strohl’s point is not that we should abandon the SAT, but rather that a student’s scores and grades should be considered in the context or what obstacles she has overcome.  Colleges and universities claim they already do this, but research suggests they do not.  Shouldn’t they?

Are New Yorkers Sicker Than Patients in Atlanta?

At a dinner party in Manhattan, someone mentions the problems he has been having with his sinuses, and his doctor’s diagnosis. Since everyone at the table is over 40, his comment quickly leads to a lively discussion of back pain, rotator cuffs, high blood pressure, skin cancer, and diverticulitis. It seems that everyone in the room has been diagnosed with something. Finally, someone asks “Are we really that old? Can’t we talk about something else?” Everyone laughs and the conversation turns to politics.

I couldn’t help but recall that evening while reading an article in the May 12 New England Journal of Medicine (NEJM) titled “Regional Variations in Diagnostic Practices”  written by a team of investigators at Dartmouth.

Taking Precautionary Action on Environmental Toxins

Last week I wrote about the President’s Cancer Panel Report which highlighted the “grievous harm” caused by environmental carcinogens and urged action that included removing the toxins from our food, water, and air that “devastate American lives.”

Achieving this is will be no easy task for a nation whose primary tool for regulating chemicals, the Toxic Substances Control Act (TSCA), was added last year to a list of government programs at “high risk” of failure by the Government Accounting Office. The Cancer Panel authors write that TSCA, passed in 1976, is a weak law that doesn’t provide the Environmental Protection Agency with enough authority and “may be the most egregious example of ineffective regulation of environmental contaminants.”

When the Act was passed, some 62,000 chemicals already on the market were declared “safe”, even though there was little or no data to support this policy. Every year another 1,000 chemicals are introduced onto the market—usually with little toxicity testing. The net result: Only 2% of the 80,000 to 100,000 chemicals currently in use have been tested for carcinogenicity and other toxicity.